KURT WILLIAM LOCKE (NPI# 1699184440) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699184440 |
| Entity Type | Individual |
| Full Name | KURT WILLIAM LOCKE |
| Credential | IDMT |
| Practice Address |
26012 Carolines Ave Andersen Afb GU 96542 |
| Mailing Address |
3625 Wasmund Ave Warren MI 48091-2448 |
| Practice Telephone | 6713665271 |
| Mailing Telephone | 2483765853 |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2014-08-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1003X |
Military Health Care Provider Specialization: Independent Duty Medical Technicians |
Other Service Providers |
| Street Address |
26012 CAROLINES AVE |
| City | ANDERSEN AFB |
| State | GU |
| Zip Code | 96542 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356759492 | John Garcia | Military Health Care Provider | 26012 Carolines Ave., Andersen Afb, GU 96542 | 2014-07-31 |
| 1972891653 | Tyler Kent Hawkins | Dentist | Building 26012 Carolines Ave, 36 Medical Group, Yigo, GU 96542 | 2011-07-15 |
| 1710121892 | Imee Sarmiento Kiser | Military Health Care Provider | 36th Mdg, Building 26012 Carolines Avenue, Andersen Afb, GU 96542 | 2009-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285288134 | Benjamin Huyck | Military Health Care Provider | 22061 Carolines Ave, Andersen Afb, GU 96929 | 2019-07-30 |
| 1235782244 | Daniel Shimanski | Military Health Care Provider | 36th Mdos, Bld 26012, Carolines Ave, Andersen Afb, GUAM 96929 | 2019-07-18 |
| 1588763536 | Andersen Phcy | Military/U.S. Coast Guard Pharmacy | Bldg 26000 Santa Rosa, Andersen Afb, GU 96543 | 2006-09-22 |
| Taxonomy Code | 1710I1003X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Medical Technicians |
| An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians. |
| Notes: Source: Air Force Surgeon General Office [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285288134 | Benjamin Huyck | Military Health Care Provider | 22061 Carolines Ave, Andersen Afb, GU 96929 | 2019-07-30 |
| 1235782244 | Daniel Shimanski | Military Health Care Provider | 36th Mdos, Bld 26012, Carolines Ave, Andersen Afb, GUAM 96929 | 2019-07-18 |
| 1356759492 | John Garcia | Military Health Care Provider | 26012 Carolines Ave., Andersen Afb, GU 96542 | 2014-07-31 |
| 1710121892 | Imee Sarmiento Kiser | Military Health Care Provider | 36th Mdg, Building 26012 Carolines Avenue, Andersen Afb, GU 96542 | 2009-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548490733 | David L Thomas | Military Health Care Provider | 1483 Bamboo Ln, Yigo, GU 96929-1201 | 2009-07-22 |
| 1891247425 | Daniel S Reid | Military Health Care Provider | 26012 Carolines Ave., Andersen Afb, Yigo, GU 96929 | 2016-10-31 |
| City | ANDERSEN AFB |
| Zip Code | 96542 |
Please comment or provide details below to improve the information on KURT WILLIAM LOCKE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.